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Cardiac Action Potential01:30

Cardiac Action Potential

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Cardiac action potentials are essential for proper heart function, enabling the rhythmic contractions needed for adequate blood circulation. Nodal cells and Purkinje fibers, specialized for electrical conduction, generate these action potentials.
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
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Electrocardiogram01:29

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An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
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Correlation between ECG and Cardiac Cycle01:25

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The electrical signals recorded on an electrocardiogram (ECG) occur before the mechanical processes of contraction and relaxation during the cardiac cycle.
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
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Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Electrocardiogram Fundamentals01:28

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Introduction
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
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The normal cardiac rhythm is a synchronized electrical activity that facilitates the regular and coordinated contraction of the heart muscle. This process is essential for efficient blood circulation throughout the body. The fundamental elements involved in establishing and maintaining this rhythm include the unique electrical properties of cardiac muscle cells, the sinoatrial (SA) node's pacemaker function, the specialized conducting system, and the ionic mechanisms underlying each phase...
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'Action potential-like' ST elevation following pseudo-Wellens' electrocardiogram.

Fatih Oksuz1, Baris Sensoy1, Fatih Sen1

  • 1Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, Ankara, Turkey.

Indian Heart Journal
|October 4, 2015
PubMed
Summary

Coronary artery vasospasm can cause serious cardiac events. This study highlights a rare pseudo-Wellens syndrome presentation in vasospastic angina, offering insights into diagnosis and treatment.

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Area of Science:

  • Cardiology
  • Internal Medicine
  • Clinical Electrocardiography

Background:

  • Coronary artery vasospasm is a significant cause of chest pain syndromes, potentially leading to myocardial infarction, arrhythmias, and sudden cardiac death.
  • Prinzmetal's angina, characterized by nonexertional chest pain and ST-segment elevation, presents diagnostic and therapeutic challenges, sometimes necessitating interventions like coronary angioplasty.
  • Calcium channel blockers are highly effective in managing and preventing coronary artery spasm, providing sustained patient relief.

Observation:

  • Wellens' syndrome typically indicates critical proximal left anterior descending stenosis with specific ECG findings (inverted T-waves, preserved R waves).
  • Pseudo-Wellens' syndrome, rarely associated with coronary artery spasm, presents a diagnostic mimicry.
  • This case details a pseudo-Wellens' syndrome in a patient with vasospastic angina, exhibiting diffuse ST-segment elevation resembling a lambda sign or 'action potential-like' ECG.

Findings:

  • The study identifies a rare electrocardiographic manifestation of vasospastic angina, mimicking Wellens' syndrome.
  • The observed 'lambda' or 'action potential-like' diffuse ST-segment elevation is linked to coronary artery spasm.
  • This presentation underscores the importance of considering vasospasm in atypical ECG findings.

Implications:

  • Recognizing this pseudo-Wellens' syndrome presentation is crucial for accurate diagnosis and timely management of vasospastic angina.
  • Effective treatment with calcium antagonists can prevent severe cardiac events associated with coronary artery spasm.
  • This case contributes to the understanding of diverse ECG presentations of coronary artery vasospasm.